Provider Demographics
NPI:1447294665
Name:PEFFER, STEPHANIE GAY (NP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GAY
Last Name:PEFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3667 MURIETTAS ROOST
Mailing Address - Street 2:P.O. BOX 4395
Mailing Address - City:DORRINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:95223
Mailing Address - Country:US
Mailing Address - Phone:209-795-4894
Mailing Address - Fax:
Practice Address - Street 1:2740 HIGHWAY 4
Practice Address - Street 2:DRAWER V
Practice Address - City:ARNOLD
Practice Address - State:CA
Practice Address - Zip Code:95223
Practice Address - Country:US
Practice Address - Phone:209-795-4488
Practice Address - Fax:209-795-0984
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP14695363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care